Risk Of Early-Onset Dementia Research Articles

Outdoor artificial light at night and risk of early-onset dementia: A case-control study in the Modena population, Northern Italy

BackgroundDementia is a neurological syndrome characterized by severe cognitive impairment with functional impact on everyday life. It can be classified as young onset dementia (EOD) in case of symptom onset before 65, and late onset dementia (LOD). The purpose of this study is to assess the risk of dementia due to light pollution, and specifically outdoor artificial light at night (LAN). MethodsUsing a case-control design, we enrolled dementia patients newly-diagnosed in the province of Modena in the period 2017–2019 and a referent population from their caregivers. We geo-referenced the address of residence on the date of recruitment, provided it was stable for the previous five years. We assessed LAN exposure through 2015 nighttime luminance satellite images from the Visible Infrared Imaging Radiometer Suite (VIIRS). Using a logistic regression model adjusted for age, sex, and education, we calculated the risk of dementia associated with increasing LAN exposure, namely using <10 nW/cm2/sr as reference and considering ≥10-<40 nW/cm2/sr intermediate and ≥40 nW/cm2/sr high exposure, respectively We also implemented non-linear assessment using a spline regression model. ResultsWe recruited 58 EOD cases, 34 LOD cases and 54 controls. Average LAN exposure levels overlapped for EOD cases and controls, while LOD cases showed higher levels. Compared with the lowest exposure, the risk of EOD associated with LAN was higher in the intermediate exposure (OR = 1.36, 95% CI 0.54–3.39), but not in the high exposure category (OR = 1.04, 95% CI 0.32–3.34). In contrast, the risk of LOD was positively associated with LAN exposure, with ORs of 2.58 (95% CI 0.26–25.97) and 3.50 (95% CI 0.32–38.87) in the intermediate and high exposure categories, respectively. The spline regression analysis showed substantial lack of association between LAN and EOD, while almost linear although highly imprecise association emerged for LOD. ConclusionsAlthough the precision of the estimates was affected by the limited sample size and the study design did not allow us to exclude the presence of residual confounding, these results suggest a possible role of LAN in the etiology of dementia, particularly of its late-onset form.

Peripheral and Central Iron Measures in Alcohol Use Disorder and Aging: A Quantitative Susceptibility Mapping Pilot Study.

Chronic excessive alcohol use has neurotoxic effects, which may contribute to cognitive decline and the risk of early-onset dementia. Elevated peripheral iron levels have been reported in individuals with alcohol use disorder (AUD), but its association with brain iron loading has not been explored. We evaluated whether (1) serum and brain iron loading are higher in individuals with AUD than non-dependent healthy controls and (2) serum and brain iron loading increase with age. A fasting serum iron panel was obtained and a magnetic resonance imaging scan with quantitative susceptibility mapping (QSM) was used to quantify brain iron concentrations. Although serum ferritin levels were higher in the AUD group than in controls, whole-brain iron susceptibility did not differ between groups. Voxel-wise QSM analyses revealed higher susceptibility in a cluster in the left globus pallidus in individuals with AUD than controls. Whole-brain iron increased with age and voxel-wise QSM indicated higher susceptibility with age in various brain areas including the basal ganglia. This is the first study to analyze both serum and brain iron loading in individuals with AUD. Larger studies are needed to examine the effects of alcohol use on iron loading and its associations with alcohol use severity, structural and functional brain changes, and alcohol-induced cognitive impairments.

Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator?

The possible mediating role of cardiovascular disease (CVD) in the relationship between alcohol use disorders (AUD) and the risk of early-onset (<age 65)and late-onset (≥age 65)dementia lacks formal investigation. Using linked Finnish national register data, a population-based cohort study of 262,703 dementia-free Finnish men and women aged 40 + at baseline (December 31, 1999)was established. AUD and CVD in 1988-2014, and incident dementia in 2000-2014 were identified from Finnish Hospital Discharge Register and/or Drug Reimbursement Register. Causal association and mediation were assessed using mediational g-formula. AUD was associated with a substantial increase in the risk of early-onset dementia in both men (hazard ratio: 5.67, 95% confidence interval: 4.37-7.46) and women (6.13, 4.20-8.94) after adjustments for confounding; but the elevated risk for late-onset dementia was smaller (men: 2.01, 1.80-2.25; women: 2.03, 1.71-2.40). Mediational g-formula results showed that these associations were causal in men with no mediation by CVD as the virtually identical total effect of AUD (early-onset: 5.26, 3.48-7.48; late-onset: 2.01, 1.41-2.87) and direct effect of AUD (early-onset: 5.24, 3.38-7.64; late-onset: 2.19, 1.61-2.96) were found with no indirect effect via CVD. In women, the results were similar for late-onset dementia (total effect: 2.80, 1.70-4.31; direct effect: 2.92, 1.86-4.62) but underpowered for early-onset dementia. AUD increased dementia risk, particularly the risk of early-onset dementia. This elevated risk of dementia associated with AUD was not mediated by CVD. Clinicians should consider the increased risk of dementia in the management of middle-aged and older adults with a history and/or current AUD.

Atrial Fibrillation and the Risk of Early-Onset Dementia: A Systematic Review and Meta-Analysis.

Background Recent studies have identified an increased risk of dementia in patients with atrial fibrillation (AF). However, both AF and dementia usually manifest late in life. Few studies have investigated this association in adults with early-onset dementia. The aim of this study was to investigate the relationship between AF and early-onset dementia. Methods and Results We searched the PubMed/MEDLINE, Embase, and Scopus databases through April 15, 2022, for studies reporting on the association between AF and dementia in adults aged <70 years, without language restrictions. Two reviewers independently performed the study selection, assessed the risk of bias, and extracted the study data. We performed a meta-analysis of early-onset dementia risk according to occurrence of AF using a random-effects model. We retrieved and screened 1006 potentially eligible studies. We examined the full text of 33 studies and selected the 6 studies that met our inclusion criteria. The pooled analysis of their results showed an increased risk of developing dementia in individuals with AF, with a summary relative risk of 1.50 (95% CI, 1.00-2.26) in patients aged <70 years, and 1.06 (95% CI, 0.55-2.06) in those aged <65 years. Conclusions In this systematic review and meta-analysis, AF was a risk factor for dementia in adults aged <70 years, with an indication of a slight and statistically imprecise excess risk already at ages <65 years. Further research is needed to assess which characteristics of the arrhythmia and which mechanisms play a role in this relationship.

Risk of early-onset dementia among persons with tinnitus: a retrospective case\u2013control study

Higher rates of poor cognitive performance are known to prevail among persons with tinnitus in all age groups. However, no study has explored the association between tinnitus and early-onset dementia. We hypothesize that tinnitus may precede or occur concurrently with subclinical or early onset dementia in adults younger than 65 years of age. This case–control study used data from the Taiwan National Health Insurance Research Database, identifying 1308 patients with early-onset dementia (dementia diagnosed before 65 years of age) and 1308 matched controls. We used multivariable logistic regressions to estimate odds ratios (ORs) for prior tinnitus among patients with dementia versus controls. Among total 2616 sample participants, the prevalence of prior tinnitus was 18%, 21.5% among cases and 14.5% among controls (p < 0.001). Multivariable logistic regression showed and adjusted OR for prior tinnitus of 1.6 for cases versus controls (95% CI: 1.3 ~ 2.0). After adjusting for sociodemographic characteristics and medical co-morbidities, patients with early-onset dementia had a 67% higher likelihood of having prior tinnitus (OR = 1.628; 95% CI = 1.321–2.006). Our findings showed that pre-existing tinnitus was associated with a 68% increased risk of developing early-onset dementia among young and middle-aged adults. The results call for greater awareness of tinnitus as a potential harbinger of future dementia in this population.

Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study

Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.

Effects of Excessive Screen Time on Neurodevelopment, Learning, Memory, Mental Health, and Neurodegeneration: a Scoping Review

Evidence suggests that chronic sensory stimulation via excessive exposure to screen time may affect brain development in negative ways. Excessive smartphone use may increase the risk of cognitive, behavioral, and emotional disorders in adolescents and young adults that also has the potential to increase the risk of early onset dementia in late adulthood. This scoping review assessed theoretical and empirical evidence for the relationships between excessive screen time and (i) neurodevelopment, (ii) learning and memory, (iii) mental health, (iv) substance use disorders, and (v) neurodegeneration. Using Halas et al.’s (BMJ Open, 5(1), 1–6; 2015) five-stage scoping review methodology, we systematically identified articles meeting the following inclusion criteria: published in English between January 1999–July 2019; human or animal subjects; primary and secondary sources including original research, systematic reviews, meta-analyses, scoping reviews, and narrative reviews. Primary search terms focused on “smartphone,” “mental health,” “substance use,” “neurodevelopment,” and “neurodegeneration”; secondary search terms focused on “social media,” “anxiety,” “cannabis,” and “dementia”. We analyzed 44 articles across 16 countries in this review. Each article corresponded to one of four research questions investigating screen time and mental health (n = 13), mental health and substance use (n = 8), chronic stress and development (n = 14), and chronic stress and neurodegeneration (n = 9). Overall increased screen time is associated with negative outcomes such as lowered self-esteem, increased incidence and severity of mental health issues and addictions, slowed learning and acquisition, and an increased risk of premature cognitive decline. Future directions to better inform public policy should expand research methodologies and explore the prolonged effects of excessive screen time on cognition and mental health in diverse populations and contexts.

Alcohol-use disorders increase risk of early-onset dementia

Alcohol-use disorders increase risk of early-onset dementia

Commentary on “Estimating the number of people with Down’s syndrome in Scotland and the cohort at elevated risk of early onset dementia”

PurposeThe purpose of this paper is to consider the implications for people with Down’s syndrome and their families of identifying those people who are at risk of developing dementia from the research study “Estimating the number of people with Down’s syndrome in Scotland and the cohort at elevated risk of early onset dementia”.Design/methodology/approachThe commentary is based on a review of the associated literature.FindingsEstimating the numbers is important but has serious implications for people who have an elevated risk and their families. Preparation and ongoing support and planning are vital to ensure that quality of life is maintained as dementia is identified and progresses.Originality/valueThe commentary considers the research presented from a practitioner perspective.

Estimating the number of people with Down’s syndrome in Scotland and the cohort at elevated risk of early onset dementia

PurposeThe purpose of this paper is to estimate the size of the population of people with Down’s syndrome in Scotland in order to provide a basis for estimating likely numbers of people with dementia in Down’s syndrome at a range of ages.Design/methodology/approachRecorded data were requested from all general practitioner (GP) services in Scotland on people with an identified READ code denoting Down’s syndrome. A statistical weighting model was then applied to account for non-response bias.FindingsThere were 3,261 people with Down’s syndrome estimated by the application of a statistical weighting model. Of these, 1,118 people (34 percent) were aged between 40 and 59. This age banding includes the age groups reported as having the highest incidence of early onset dementia in Down’s syndrome.Research limitations/implicationsIt is not possible to apply a benchmark to the percentage of observed data which gives an indication of how accurate the estimates produced are. Rather, the quality of the estimates depends on the response rate itself and the extent to which response is correlated with the outcome variable. In short, the quality of the final weighted estimates depends on the extent to which the biasing effect is mitigated by the weighting. As a result, a different response rate to this survey would have resulted in variations in the weighting model and therefore provided a different set of estimates.Social implicationsAdults with Down’s syndrome have an elevated risk of developing dementia significantly earlier than the general population and require specific age appropriate supports and services to meet their needs both pre and post-diagnosis. The reality of this is currently not fully realized in either standard practice or national policy concerning the issue.Originality/valueThis is the first set of data collected from GP services in Scotland to examine this issue and attempt to identify the population of people with Down’s syndrome in Scotland as a whole.

Predictors of early-onset cognitive impairment.

Dementia is a major global health crisis with an estimated 35 million people diagnosed at present, and that number is projected to triple by 2050. Many more suffer from mild cognitive impairment (MCI), which is recognized as a precursor for many types of dementia (Petersen et al. , 2014). At the recent G8 Summit in London, health ministers from participating countries discussed dementia and its treatment and prevention (Fox and Petersen, 2013), and issued a communique calling for increased research into the mechanisms of disease, and increased efforts targeted at prevention (G8 Summit, 2013). To that end, the identification of lifestyle factors that may contribute to the development of dementia is crucial. In the current issue of Brain , Nyberg and colleagues present data from a longitudinal study in which they reveal the contribution of two such factors—early cardiovascular fitness and cognitive fitness—to the risk of early-onset dementia and MCI (Nyberg et al. , 2014). Longitudinal studies such as these are much needed. In 2010, an NIH ‘State of the Science’ report concluded that there was insufficient evidence to support the use of pharmaceutical agents, dietary supplements or other means for the prevention of cognitive decline or Alzheimer’s disease (NIH State-of-the-Science, 2010). Having reviewed the literature, attendees at the conference concluded that the appropriate longitudinal studies had not been conducted to validate any interventions. Of note, studies that …

Accelerated Aging, Decreased White Matter Integrity, and Associated Neuropsychological Dysfunction 25 Years After Pediatric Lymphoid Malignancies

CNS-directed chemotherapy (CT) and cranial radiotherapy (CRT) for childhood acute lymphoblastic leukemia or lymphoma have various neurotoxic properties. This study aimed to assess their impact on the maturing brain 20 to 30 years after diagnosis, providing a much stronger perspective on long-term quality of life than previous studies. Ninety-three patients treated between 1978 and 1990 at various intensities, with and without CRT, and 49 healthy controls were assessed with magnetic resonance diffusion tensor imaging (DTI) and neuropsychological tests. Differences in fractional anisotropy (FA)-a DTI measure describing white matter (WM) microstructure-were analyzed by using whole brain voxel-based analysis. CRT-treated survivors demonstrated significantly decreased FA compared with controls in frontal, parietal, and temporal WM tracts. Trends for lower FA were seen in the CT-treated survivors. Decreases in FA correlated well with neuropsychological dysfunction. In contrast to the CT group and controls, the CRT group showed a steep decline of FA with age at assessment. Younger age at cranial irradiation and higher dosage were associated with worse outcome of WM integrity. CRT-treated survivors show decreased WM integrity reflected by significantly decreased FA and associated neuropsychological dysfunction 25 years after treatment, although effects of CT alone seem mild. Accelerated aging of the brain and increased risk of early onset dementia are suspected after CRT, but not after CT.